Integrative Body-Mind-Spirit Social Work: An Empirically Based Approach to Assessment and Treatment, is the first book to strongly connect Western therapy with Eastern philosophy and practices, while also providing a comprehensive practice agenda for social work and mental health professionals. The authors argue that integrative body-mind-spirit social work is indeed a practical therapeutic approach in bringing about tangible changes in clients. In the excerpt below we look at just one technique and one patient, Rebecca.The authors are highly regarded researchers from both Asia and America. Mo Yee Lee is a Professor in the College of Social Work at The Ohio State University. Siu-man Ng is an Assistant Professor in the Department of Social Work and Social Administration and the Associate Director of the Centre on Behavioral Health at the University of Hong Kong. Pamela Pui Yu Leung is an Assistant Professor in the Department of Social Work and Social Administration at the University of Hong Kong. Cecilia Lai Wan Chan is a Professor in the Department of Social Work and Social Administration, the Director of the Centre on Behavioral Health, the Associate Director of the HKJC Centre for Suicide Research and Prevention at the University of Hong Kong.
Rebecca was a lady in her thirties. When she first came to the therapist’s office, she talked with a soft and weak voice and seemed afraid of looking directly at the therapist. She did not clearly express what she wanted. She gave the therapist the impression that she was a timid, little girl instead of a woman in her late thirties. After building rapport, she shared with the therapist that she was thinking about changing careers but was not certain about what she could do. She hoped the therapist could help her develop self-confidence so that she could take charge of her life.
In the first few sessions, the therapist helped Rebecca to explore and clarify what she wanted. She wanted to make some changes in her life, but she was afraid of the uncertainty that would go with the change. She realized that she was stuck because she was used to staying with the familiar and not taking risks. Rebecca also discovered that she had made herself psychologically dependent on others, her father in particular. This dependence had developed into a pattern so that she always relied on others to make decisions for her. Though there was an inner voice calling her to meet a new challenge and attempt a new job, she dared not, as her father did not support the idea.
During the fifth session, the therapist revisited the treatment goal with Rebecca and tried to help her to make a choice for herself regarding her pattern of being dependent on others. The therapist said, “You told me that your goal is to take charge of your life. Now you realize that you have developed a pattern of being dependent on others. What are you going to do with this pattern? Do you want to keep it, or change it?” Rebeca promptly responded that she did not want to keep the old pattern, but having been used to relying on others for so many years, she felt uncertain of what she could do if she was on her own. She said, “I have not yet figured out how to make a change. In my conscious mind, I am aware that I choose to stay with the familiar, to stay in the comfort zone. I tend to rely on others. However, the current pattern is most comfortable to me. I don’t know how I can survive without relying on others’ support.”
It came to the therapist’s mind that utilizing the conscious mind alone would not help Rebecca in moving further ahead. The therapist decided to intervene using the experiential approach, utilizing not only the mind but also the body. The therapist said, “Having heard what you have just said, I have developed a picture in my mind. Would you like me to share it with you?” With Rebecca’s consent, the therapist created the picture by putting a hula hoop on the floor around her to represent her comfort zone. Rebecca was asked to kneel down. The therapist then put many cushions around the hula hoop so that Rebecca was surrounded and protected by the cushions. When asked by the therapist how well the scenario created represented her current psychological state, Rebecca said, “Yes. I was just hiding myself like this. It was quite safe.” The therapist went on asking Rebecca how her body felt in such a position.
She said, “Actually it’s not very comfortable. People may not be able to see me…I am very small…I don’t want to be like this.”
“So what do you want?” asked the therapist.
After thinking for a while, Rebecca said, still in a weak voice, “I want to stand up.”
The therapist said to her, “How can you do that? As long as you continue to stay in your comfort zone and relying on others, you cannot stand on your own feet.”
Rebecca said, in a louder voice, “I really don’t want to be like this. I want to stand up. I have to rely on myself.” At that moment, Rebecca stood up. She had made a new choice. The therapist continued to utilize both the body and the mind to consolidate the change: “If you were to rely on yourself and take charge of your life, how would you be different? What would your whole body be like?…Take a deep breath. You may close your eyes. Try to get in touch with your life force…(Rebecca closed her eyes and focused on her breathing.) What would your posture and body position be like?…If you wish, allow yourself to move. Allow yourself to stand anywhere, in any position that you think fits…Make yourself comfortable, assume a posture in which you feel you are grounded and firm…Allow your body to use its own way to express yourself…Give yourself permission, give yourself freedom, be in whatever way fits you…” Moving her hands, body, and feet slowly, Rebecca finally stepped out of the hula hoop and stood upright. She took a deep breath and smiled.
When Rebecca opened her eyes, the therapist asked her what she experienced in the exercise. She said in a calm voice that she had set herself free. She said that she had made a choice to stand up and not to be dependent on others. When asked about the meaning of standing up, Rebecca said, “Standing up means that I am competent. It means that I have internal strength and resources.” The therapist then asked Rebecca to list the strengths and resources she found in herself…
…The therapist asked, “What is your body like when you are taking charge of and connecting with yourself?”
Standing straight yet relaxed, Rebecca took a deep breath and said, “I stand up firm and feel grounded. I believe I can lead my life in ways I desire.”…She also said that, at that moment, she realized that she was no longer the dependent little girl. She was in touch with her mature and independent self. When asked what she meant by “be her own self,” Rebecca said, “I am Rebecca. I have many gifted talents. I am competent, I am curious, I am loveable. I appreciate myself.”
When Rebecca returned home that evening, she talked to her father about her plan of changing careers. In the next session, she reported that she no longer felt afraid of her father when she expressed herself. She believed that she had been transformed.